Assessment – VitaCure+

How familiar are you with GLP-1 peptides?

New to me Basic understanding I've done my homework on these medications I have personal experience with GLP-1 medications

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What is your gender?

Male Female Non-binary Prefer not to say

Which of the following are you most concerned about?

Have you been diagnosed with diabetes?

Type 1 Type 2 No

How often are you exercising lately?

3+ times a week 1-2 times per week Few times per month Not at all

How much water do you typically drink per day?

A lot
More than 2 liters Moderate amount
Between 1-2 liters Not much
Less than under a liter

Are you currently pregnant, trying to get pregnant, or breastfeeding?

Yes No

Do you have ANY of the following medical conditions?

● Heart disease
● Kidney disease
● Liver disease
● Personal or family history of thyroid disorders (hyperthyroid, hypothyroid, Medullary Thyroid Carcinoma or Multiple Endocrine Neoplasia syndrome type 2)
● Digestive or intestinal disorders (IBS, Crohn’s, ulcerative colitis, severe GERD)
● Active cancer
● Autoimmune disorders
● Blood clotting disorders
● Sever mental health conditions
● Currently under immunosuppressive therapy

Yes No

Have you ever struggled with drug or alcohol misuse?

Yes No

Your Height (cm):

170 cm

Your Height (ft + in):

5 ft 7 in

Your current weight (kg):

130 kg

Your current weight (lbs):

286 lbs

Introducing: VitaCure GLP-1 Therapy

Your Height (cm):

Your Height (ft + in):

Your current weight (kg):

Your current weight (lbs):